If you’ve hung around here long enough you know that our primary goal is to help you look like you – and only you get to decide what that look is. Proudly rocking scars, stretch marks, and body hair is something we celebrate. And we’re also happy to help if that’s not so much your jam. No judgement either way.
If addressing scars left over from acne is something you’re interested in, we understand. We’ve put together a complete guide discussing the different types of acne scarring, some of the root causes, and a few options for treatment. There is a dizzying array of technologies and theories for addressing acne and scarring – making the approach to treatment very overwhelming. This is why having a really good provider who knows you and your skin well is often the key to success.
What Causes Acne-Scarring?
Just like acne itself, the causes of scarring are many and varied. A breakout can cause scarring when there is damage to the skin’s tissue – as the body heals the damaged tissue, a scar is formed. Individuals with cystic acne tend to be more prone to scarring after a breakout. The two other big factors are genetics (surprise, surprise) and whether you tend to pick at or try to pop pimples and acne. Pickers and poppers, we know you probably know not to do it so we won’t nag you about it
There are two different types of scarring: atrophic and hypertrophic scarring. Atrophic scars are characterized by depressions within the skin, they form when the body produces too little collagen in its attempt to repair the skin after it’s been damaged. Hypertrophic scars are raised scars, and these occur when an over abundance of collagen is produced during the skin’s healing process. The treatment plan we prescribe for you will really depend on the type of scarring you experience.
If, after a breakout you notice small, flat patches of discolouration where your breakout once was, you are probably suffering from post-inflammatory hyperpigmentation. These aren’t scars but marks leftover from the skin’s healing process. In some individuals, the body produces too much melanin as it is healing a wound or trauma to the skin and leaves behind pigmented spots where the initial injury occurred. The good news is that these tend to be a lot easier to target than true acne scars and are typically treated with a combination of peel treatments and a light based therapy like Intense Pulsed Light.
Our Top Three Treatments for Acne Scarring
Which treatments we prescribe depend on the type of scarring you are prone to as well as a host of other factors including whether you still experience active breakouts. A consultation is key to success and it’s important to keep in mind that some individuals may require on-going treatment as opposed to a one and done approach.
Morpheus8
Our newest technology for treating acne as well as acne scars is Morpheus8. RF microneedling helps to resurface the skin and break up scar tissue, destroying the bacteria that causes acne in the process. Three sessions spaced 4-6 weeks apart are recommended. Morpheus 8 is not a super comfortable treatment to sit through, you’ve been warned. But the results can be really incredible. Take a deeper dive into this treatment by reading all about our patient’s experience with the procedure.
Best for: both atrophic and hypertrophic scarring and those experiencing active acne. May also help to improve some PIH.
Microneedling with Hyaluronic Acid and/or PRP
Microneedling has been a provider favourite for all kinds of skin rejuvenation, including for improving the look of acne scarring. However, we can’t perform this treatment on anyone with active acne, as the device we use for the needling can spread bacteria across the skin and make breakouts worse.
A regimen to reduce acne breakouts is recommended prior to undergoing microneedling with hyaluronic acid or PRP. Benefits can be seen for individuals with all type of scarring, however atrophic scarring may be best suited to microneedling with hyaluronic acid, and hypertrophic scarring is typically treated with PRP. We recommend a series of 3 treatments one month apart.
Best for: atrophic and hypertrophic scarring, as well as PIH.
Dermal Fillers and Threads
For individuals with deep, depressed scars we may recommend either dermal filler injection or thread lifting, or a combination of both.
Hyaluronic filler can be injected directly into the depressed scars. The goal here is to fill the concavities to create a more uniform look to the skin. However, there are of course limitations to this approach. High-risk areas like the temples and forehead should only be treated by a very skilled, experienced injector. The risk of uniformity is high as filling in small scars is a laborious, painstaking process. It is best suited for very large craters.
A better option for most depressed scars is thread lifting, depicted below. These threads can be inserted in and around the scarred skin. They create a simultaneous lifting and filling effect, pulling the skin taught and smoothing the look of the skin. After insertion, the skin continues to produce collagen in the treated area, which helps to improve the scars further.
Best for: atrophic scarring
